White House scrambles to fix health bill language on covering sick kids

The White House is seeking to nail down a provision in the new law it says bars insurers from denying coverage to sick kids starting this year.

Several speeches by the president suggested that the bill "would immediately stop insurers from denying coverage to children with pre-existing medical conditions,… [b]ut health advocates and some insurers say the law does not clearly state that such protection starts this year," Kaiser Health News reports. "If it doesn't, uninsured children with pre-existing conditions might not get help until 2014, when the law requires insurers to issue policies for all applicants regardless of health condition. … Responding to the concerns, Obama administration officials said Wednesday the law does prohibit insurers from denying children coverage starting this year, but they will issue clarifying regulations." Health and Human Services spokesman Nick Papas said that to "ensure that there is no ambiguity on this point, the Secretary of HHS is preparing to issue regulations next month making it clear that the term 'pre-existing exclusion' applies to both a child's access to a plan and to his or her benefits once he or she is in the plan" (Galewitz and Villegas, 3/24).

The Wall Street Journal: "It's not clear whether a regulation would settle the matter. 'You can issue something like that, but the chance is you'll be challenged in court and the courts would interpret it,' said Diann Howland of the American Benefits Council. An HHS spokesman said the agency is confident the regulation will pass legal muster. Robert Zirkelbach, a spokesman for America's Health Insurance Plans, the industry's main lobby group, said insurers plan to implement rules as they are spelled out in the legislation. He wouldn't say what they would do if a regulation were issued" (Meckler and Adamy, 3/25).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.